Pregnancy

Pelvic Girdle Pain: Why Walking Hurts

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Pelvic girdle pain, or SPD, is pain over the pubic bone, hips, or lower back that flares when you walk, climb stairs, or roll over in bed. It comes from pregnancy-loosened pelvic joints moving unevenly. It is common and treatable, and physiotherapy is the main approach rather than something to endure.

Last updated: July 2026

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What is pelvic girdle pain in pregnancy?

Pelvic girdle pain is discomfort in the joints that link the pelvic bones, the pubic joint at the front and the sacroiliac joints at the back, as they become more mobile during pregnancy. Hormonal changes and the growing load loosen the ligaments so the joints move slightly out of sync, which the body registers as pain. The older name, symphysis pubis dysfunction, refers to the pubic joint specifically, while pelvic girdle pain covers the whole ring. According to antenatal care guidance, this is a recognized, treatable condition rather than an inevitable part of pregnancy 1. It ranges from a mild ache to pain that makes walking and turning over in bed genuinely difficult.

What does pelvic girdle pain feel like?

Pelvic girdle pain typically feels like a deep ache or sharp catch over the pubic bone, in the hips, groin, or lower back, sometimes shooting into the thighs. Movements that load one leg at a time make it worse, such as walking, stairs, getting out of a car, rolling over in bed, or standing on one leg to dress. Some people hear or feel a grinding or clicking at the pubic joint, and pain often intensifies by the end of the day. It overlaps with, but differs from, ordinary back pain in pregnancy and from sciatica, which shoots down the leg from the spine. Naming the pattern helps target the right treatment.

How is pelvic girdle pain treated?

Physiotherapy is the cornerstone of care for pelvic girdle pain, and evidence-based guidelines recommend referral to a physiotherapist with pelvic experience 1. Treatment often includes tailored exercises to stabilize the pelvis and core, manual therapy, advice on movement and posture, and a supportive pelvic belt for some people. According to ACOG, staying active within comfortable limits is generally safe, with about 150 minutes of moderate activity a week recommended in an uncomplicated pregnancy, and equal-weight movements reduce strain 2. Simple aids like a pillow between the knees at night, a pelvic floor physical therapy program, and pacing can meaningfully lower pain. Most people improve with the right support rather than bed rest.

Will pelvic girdle pain go away after birth?

Pelvic girdle pain usually improves substantially after birth as hormones settle and the joints regain stability, often within the first 6 to 8 weeks postpartum 3. For some, milder symptoms linger longer, and postnatal physiotherapy can speed recovery when pain persists 3. It can begin in any trimester, occasionally in the first but more often from around 20 weeks as the load grows, and it tends to recur in later pregnancies, sometimes starting earlier each time 1. According to postnatal care guidance, ongoing pelvic pain after delivery is a recognized reason to seek continued support rather than assume it must resolve alone 3. Early treatment in one pregnancy can make the next more manageable, and letting your maternity team know about a previous episode helps them plan ahead.

When pelvic girdle pain needs a clinician

Pelvic girdle pain is treatable, so raising it with a clinician early tends to bring faster relief than waiting it out. Pain that limits walking, wakes you at night, or makes daily tasks hard is reason enough to ask for a physiotherapy referral 1. Certain features need more urgent review: one-sided calf pain, swelling, warmth, or redness can suggest a blood clot rather than joint pain and warrants same-day assessment 4. Fever, severe pain, or a feeling that the pelvis is giving way also deserve prompt evaluation. Gale can help you describe your symptoms and prepare for a prenatal appointment. Support is available, and enduring it silently is not the only option.

Common questions

Largely, yes. Symphysis pubis dysfunction, or SPD, is an older name that focuses on the pubic joint at the front of the pelvis. Pelvic girdle pain is the broader, current term covering the pubic joint and the sacroiliac joints at the back. Both describe pain from the pelvic joints moving unevenly in pregnancy, and both respond to similar physiotherapy-led care.

Usually yes, within comfortable limits and ideally guided by a physiotherapist. Gentle, symmetrical activity that avoids loading one leg at a time is often better tolerated than high-impact movement. A physiotherapist can tailor exercises to stabilize the pelvis, and staying active in a modified way tends to help more than complete rest.

No. Pelvic girdle pain reflects loosened, unevenly moving joints, not a problem that dictates how you give birth. Most people can plan a vaginal birth, and positions that keep the legs from spreading too far can be discussed with your maternity team. Your clinician and physiotherapist can help plan comfortable options.

For many people it eases substantially within the first several weeks after birth as hormones and joint stability return. Milder symptoms can linger longer, and postnatal physiotherapy helps when pain persists. Ongoing pelvic pain after delivery is a recognized reason to seek continued support rather than wait it out alone.

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When pelvic pain in pregnancy needs care

  • —Pelvic or pubic pain that limits walking, wakes you at night, or disrupts daily tasks is a reason to ask for a physiotherapy referral
  • —One-sided calf pain, swelling, warmth, or redness is a reason to seek same-day review for a possible blood clot
  • —Fever with pelvic pain, or a feeling that the pelvis is giving way, is a reason to seek prompt clinician evaluation
  • —Pelvic pressure or cramping with contractions before 37 weeks is a reason to contact your maternity unit urgently
  • —Vaginal bleeding or fluid leaking with pelvic pain is a reason to seek same-day maternity assessment

If you have sudden severe calf pain with swelling, chest pain or breathlessness, heavy vaginal bleeding, or constant severe abdominal pain, call 911 or go to the nearest emergency department right away.

This article is general health education, not medical advice. Whether your pelvic pain is pelvic girdle pain and how best to treat it should be assessed by your obstetric clinician, midwife, or physiotherapist.

References

  1. 1.National Institute for Health and Care Excellence (2024). Antenatal care (NG201). National Institute for Health and Care Excellence (NICE). link ✓Antenatal care guidance recognizing pelvic girdle pain as a treatable condition and recommending referral to physiotherapy; supports the definition, management, and onset framing.
  2. 2.American College of Obstetricians and Gynecologists (2020). Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000003772 ✓ACOG guidance recommending about 150 minutes of moderate activity a week in uncomplicated pregnancy and that staying active is safe; supports the activity and self-management advice.
  3. 3.National Institute for Health and Care Excellence (2026). Postnatal care (NG194). National Institute for Health and Care Excellence (NICE). link ✓Postnatal care guidance covering the first weeks after birth and continued support for persistent pelvic pain; supports the postpartum recovery timeline and postnatal physiotherapy.
  4. 4.American College of Obstetricians and Gynecologists (2018). ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000002706 ✓Guidance on thromboembolism in pregnancy and its warning signs including one-sided calf pain, swelling, warmth, and redness; supports the blood-clot red flag distinct from joint pain.

4 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy

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